Prognostic Factor Affecting the Outcome of Bone Metastasis from Hepatocellular Carcinoma

影響肝細胞癌骨頭轉移的預後因子

劉建鴻(Cheng-Hong Liou) ； 劉幕台(Mu-Tai Liu) ； 黃文濤(Wen-Tau Huang) ； 王愛義(Ai-Yih Wang) ； 黃昭源(Chao-Yuan Huang) ； 畢祖平(Chu-Ping Pi) ； 張東浩(Tung-Hao Chang) ； 許智捷(Chih-Chieh Hsu) ； 黃家俊(Chia-Chun Huang)

《放射治療與腫瘤學》 18卷2期 (2011/06) Pp. 89-96

https://doi.org/10.6316/TRO/201118(2)89

摘要

目的：本篇研究的目的是針對肝細胞癌有骨頭轉移的患者，評估他們的存活率和預後因子。材料與方法：從1999年6月到2005年1月，總共有69位病人診斷肝細胞癌擁有骨頭轉移在我們醫院接受治療。本研究分析的變因包括診斷骨頭轉移時的性別、年齡、肝硬化Child's分期、Okuda系統、治療骨頭轉移的方式等。結果：52位(75.4%)是男性，17位(24.6%)是女性。診斷肝癌的年齡中位數是66歲。在存活方面，從診斷骨頭轉移那天算起，存活期的中位數為3.06個月，6個月、1年、2年的存活率(overall survival)分別為30.43%，11.59%和5.80%。在單一變數分析中，肝硬化Child's分期(p=0.0022)、Okuda系統(p=0.0002)和病人整體狀況(p=0.0277)都是有意義的預後因子。在多變數分析中，病人整體狀況(p=0.003)是有意義的預後因子。結論：肝細胞癌有骨頭轉移患者的預後不佳，為了改善預後，我們需要收集更多的患者，並安排合併肝癌局部治療和全身系統治療的臨床試驗。

關鍵字

肝細胞癌 ； 骨頭轉移

並列摘要

Purpose: The purpose of this study is to analyze the overall survival rate of patients with bone metastasis from hepatocellular carcinoma (HCC) and prognostic factors affecting their outcomes.Materials and Methods: From June 1999 to January 2005, there were 69 patients with bone metastasis from HCC who were treated at our hospital. The variables, such as gender, age of diagnosis of bone metastasis, Pugh's modification of Child's grading of cirrhosis Okuda staging system, performance status, serum level of α-fetoprotein at diagnosis of bone metastasis from HCC, methods of treatment for bone metastasis, site of bone metastasis and metastasis to organ other than bones were analyzed about their influence upon prognosis.Results: Fifty-two patients (75.4%) are male and 17 patients (24.6%) are female. The medium age of diagnosis of bone metastasis was 66 years old (range from 31 to 78 years old). The medium survival from diagnosis of bone metastasis was 3.06 months. The 6-month, 1-year and 2-year overall survival rates were 30.43%, 11.59% and 5.80%, respectively. In univariate analysis, Child's grading of cirrhosis (p=0.0022), Okuda staging system (p=0.0002), and performance status (p=0.0277) were statistically significant factors for survival. In multivariate analysis, performance status (p=0.003) was the only significant prognostic factor.Conclusion: The survival of patients with bone metastasis from HCC was poor. To improve the outcome, we should enroll more patients and arrange prospective trial by combination of locoregional and systemic therapy.

並列關鍵字

HCC ； Bone metastasis